Serveur d'exploration sur le patient édenté

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Piezosurgery in implant dentistry

Identifieur interne : 006193 ( Ncbi/Merge ); précédent : 006192; suivant : 006194

Piezosurgery in implant dentistry

Auteurs : Stefan Stübinger [Suisse] ; Andres Stricker [Allemagne] ; Britt-Isabelle Berg [Suisse, États-Unis]

Source :

RBID : PMC:4646478

Abstract

Piezosurgery, or the use of piezoelectric devices, is being applied increasingly in oral and maxillofacial surgery. The main advantages of this technique are precise and selective cuttings, the avoidance of thermal damage, and the preservation of soft-tissue structures. Through the application of piezoelectric surgery, implant-site preparation, bone grafting, sinus-floor elevation, edentulous ridge splitting or the lateralization of the inferior alveolar nerve are very technically feasible. This clinical overview gives a short summary of the current literature and outlines the advantages and disadvantages of piezoelectric bone surgery in implant dentistry. Overall, piezoelectric surgery is superior to other methods that utilize mechanical instruments. Handling of delicate or compromised hard- and soft-tissue conditions can be performed with less risk for the patient. With respect to current and future innovative surgical concepts, piezoelectric surgery offers a wide range of new possibilities to perform customized and minimally invasive osteotomies.


Url:
DOI: 10.2147/CCIDE.S63466
PubMed: 26635486
PubMed Central: 4646478

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PMC:4646478

Le document en format XML

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</TEI>
<pmc article-type="review-article">
<pmc-dir>properties open_access</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Clin Cosmet Investig Dent</journal-id>
<journal-id journal-id-type="iso-abbrev">Clin Cosmet Investig Dent</journal-id>
<journal-id journal-id-type="publisher-id">Clinical, Cosmetic and Investigational Dentistry</journal-id>
<journal-title-group>
<journal-title>Clinical, Cosmetic and Investigational Dentistry</journal-title>
</journal-title-group>
<issn pub-type="epub">1179-1357</issn>
<publisher>
<publisher-name>Dove Medical Press</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">26635486</article-id>
<article-id pub-id-type="pmc">4646478</article-id>
<article-id pub-id-type="doi">10.2147/CCIDE.S63466</article-id>
<article-id pub-id-type="publisher-id">ccide-7-115</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Review</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Piezosurgery in implant dentistry</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Stübinger</surname>
<given-names>Stefan</given-names>
</name>
<xref ref-type="aff" rid="af1-ccide-7-115">1</xref>
<xref ref-type="corresp" rid="c1-ccide-7-115"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Stricker</surname>
<given-names>Andres</given-names>
</name>
<xref ref-type="aff" rid="af2-ccide-7-115">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Berg</surname>
<given-names>Britt-Isabelle</given-names>
</name>
<xref ref-type="aff" rid="af3-ccide-7-115">3</xref>
<xref ref-type="aff" rid="af4-ccide-7-115">4</xref>
</contrib>
</contrib-group>
<aff id="af1-ccide-7-115">
<label>1</label>
Hightech Research Center of Cranio-maxillofacial Surgery, University of Basel, Allschwil, Switzerland</aff>
<aff id="af2-ccide-7-115">
<label>2</label>
Private Practice, Konstanz, Germany</aff>
<aff id="af3-ccide-7-115">
<label>3</label>
Department of Cranio-maxillofacial Surgery, University Hospital Basel, Basel, Switzerland</aff>
<aff id="af4-ccide-7-115">
<label>4</label>
Division of Oral and Maxillofacial Radiology, Columbia University Medical Center, New York, NY, USA</aff>
<author-notes>
<corresp id="c1-ccide-7-115">Correspondence: Stefan Stübinger, Hightech Research Center of Cranio-maxillofacial Surgery, University of Basel, 14–16 Gewerbestrasse, Allschwil 4123, Switzerland, Email
<email>stefan.stuebinger@unibas.ch</email>
</corresp>
</author-notes>
<pub-date pub-type="collection">
<year>2015</year>
</pub-date>
<pub-date pub-type="epub">
<day>11</day>
<month>11</month>
<year>2015</year>
</pub-date>
<volume>7</volume>
<fpage>115</fpage>
<lpage>124</lpage>
<permissions>
<copyright-statement>© 2015 Stübinger et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License</copyright-statement>
<copyright-year>2015</copyright-year>
<license>
<license-p>The full terms of the License are available at
<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>
. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.</license-p>
</license>
</permissions>
<abstract>
<p>Piezosurgery, or the use of piezoelectric devices, is being applied increasingly in oral and maxillofacial surgery. The main advantages of this technique are precise and selective cuttings, the avoidance of thermal damage, and the preservation of soft-tissue structures. Through the application of piezoelectric surgery, implant-site preparation, bone grafting, sinus-floor elevation, edentulous ridge splitting or the lateralization of the inferior alveolar nerve are very technically feasible. This clinical overview gives a short summary of the current literature and outlines the advantages and disadvantages of piezoelectric bone surgery in implant dentistry. Overall, piezoelectric surgery is superior to other methods that utilize mechanical instruments. Handling of delicate or compromised hard- and soft-tissue conditions can be performed with less risk for the patient. With respect to current and future innovative surgical concepts, piezoelectric surgery offers a wide range of new possibilities to perform customized and minimally invasive osteotomies.</p>
</abstract>
<kwd-group>
<title>Keywords</title>
<kwd>implantology</kwd>
<kwd>piezoelectric device</kwd>
<kwd>piezosurgery</kwd>
<kwd>maxillary sinus elevation</kwd>
<kwd>bone grafting</kwd>
<kwd>osteotomy</kwd>
<kwd>edentulous ridge splitting</kwd>
</kwd-group>
</article-meta>
</front>
<floats-group>
<fig id="f1-ccide-7-115" position="float">
<label>Figure 1</label>
<caption>
<p>Piezoelectric preparation of an implant site (right maxilla).</p>
<p>
<bold>Notes:</bold>
After definition of the initial implant length, widening of the implant hole, using different tips in an ascending order (
<bold>A</bold>
<bold>C</bold>
). Finally, control of the angulation and implant placement (
<bold>D</bold>
).</p>
</caption>
<graphic xlink:href="ccide-7-115Fig1"></graphic>
</fig>
<fig id="f2-ccide-7-115" position="float">
<label>Figure 2</label>
<caption>
<p>Removal of an infected blade implant (left mandible).</p>
<p>
<bold>Notes:</bold>
Following tissue-protective piezo-osteotomy (
<bold>A</bold>
and
<bold>B</bold>
), the blade implant could be safely removed (
<bold>C</bold>
and
<bold>D</bold>
). The vestibular bone was used for bony reconstruction of the defect.</p>
</caption>
<graphic xlink:href="ccide-7-115Fig2"></graphic>
</fig>
<fig id="f3-ccide-7-115" position="float">
<label>Figure 3</label>
<caption>
<p>Sinus elevation with simultaneous implant placement.</p>
<p>
<bold>Notes:</bold>
Removal of the vestibular alveolar wall (
<bold>A</bold>
), elevation of the Schneiderian membrane and dental implant placement (
<bold>B</bold>
). The sinus cavity was filled with bone substitutes and bone chips. Use of the buccal bone for additional stabilization and protection (
<bold>C</bold>
and
<bold>D</bold>
). The complete area was finally covered with a collagen membrane (
<bold>E</bold>
).</p>
</caption>
<graphic xlink:href="ccide-7-115Fig3"></graphic>
</fig>
<fig id="f4-ccide-7-115" position="float">
<label>Figure 4</label>
<caption>
<p>Removal of sinus septum.</p>
<p>
<bold>Notes:</bold>
During a sinus elevation (
<bold>A</bold>
), a septum in the sinus was meticulously removed with a piezoelectric device (
<bold>B</bold>
). The thin and small tips allowed gentle removal of the septum. Finally, the sinus membrane could be elevated without problems (
<bold>C</bold>
). The septum was used for augmentation (
<bold>D</bold>
).</p>
</caption>
<graphic xlink:href="ccide-7-115Fig4"></graphic>
</fig>
<fig id="f5-ccide-7-115" position="float">
<label>Figure 5</label>
<caption>
<p>Harvesting of a corticocancellous ramus bone graft (right mandible).</p>
<p>
<bold>Notes:</bold>
The osteotomy of the bone graft could be easily performed with the piezoelectric device, after preparation of a mucoperiosteal flap (
<bold>A</bold>
and
<bold>B</bold>
). The bone graft was secured with two titanium screws (right upper jaw) (
<bold>C</bold>
).</p>
</caption>
<graphic xlink:href="ccide-7-115Fig5"></graphic>
</fig>
<fig id="f6-ccide-7-115" position="float">
<label>Figure 6</label>
<caption>
<p>Minimally invasive augmentation procedure (right mandible).</p>
<p>
<bold>Notes:</bold>
Two vertical incisions (
<bold>A</bold>
) were performed (mesial and distal ends of the intended region for augmentation), followed by elevation of a mucoperiosteal flap. A bone graft from the contralateral side was harvested (
<bold>B</bold>
). The block was adapted to the defect (
<bold>C</bold>
), and inserted under the flap accessed from the mesial incision (
<bold>D</bold>
). The block was secured with two titanium screws onto the alveolar crest (
<bold>E</bold>
).</p>
</caption>
<graphic xlink:href="ccide-7-115Fig6"></graphic>
</fig>
<fig id="f7-ccide-7-115" position="float">
<label>Figure 7</label>
<caption>
<p>Harvesting of ideally shaped bone graft from the zygomatic bone.</p>
<p>
<bold>Notes:</bold>
In a similar way to a sinus elevation, the bone graft was carefully removed without damaging the underlying sinus membrane (
<bold>A</bold>
<bold>C</bold>
). The slightly curved bone graft was placed in a vestibular bone defect (maxilla) and secured with two screws (
<bold>D</bold>
).</p>
</caption>
<graphic xlink:href="ccide-7-115Fig7"></graphic>
</fig>
<fig id="f8-ccide-7-115" position="float">
<label>Figure 8</label>
<caption>
<p>Ridge splitting (right mandible).</p>
<p>
<bold>Notes:</bold>
The transversally thin alveolar ridge was osteotomized with an OT7 piezo tip (
<bold>A</bold>
). After careful expansion and placement of titanium wedges, the implant holes were drilled (
<bold>B</bold>
and
<bold>C</bold>
). Two dental implants were placed in the widened alveolar ridge (
<bold>D</bold>
). The remaining space was augmented with bone substitutes (
<bold>E</bold>
). Finally, the complete area was covered with a collagen membrane (
<bold>F</bold>
).</p>
</caption>
<graphic xlink:href="ccide-7-115Fig8"></graphic>
</fig>
<fig id="f9-ccide-7-115" position="float">
<label>Figure 9</label>
<caption>
<p>Lateralization of the inferior alveolar nerve (right mandible).</p>
<p>
<bold>Notes:</bold>
Complete removal of the vestibular bone in that area and gentle loosening of the nerve (from the remaining nerve canal walls) (
<bold>A</bold>
). The nerve was carefully kept away from the osteotomy site (
<bold>B</bold>
). After implant insertions, the nerve was returned to its original place (
<bold>C</bold>
).</p>
</caption>
<graphic xlink:href="ccide-7-115Fig9"></graphic>
</fig>
</floats-group>
</pmc>
<affiliations>
<list>
<country>
<li>Allemagne</li>
<li>Suisse</li>
<li>États-Unis</li>
</country>
<region>
<li>Bade-Wurtemberg</li>
<li>District de Fribourg-en-Brisgau</li>
<li>État de New York</li>
</region>
<settlement>
<li>Constance (Allemagne)</li>
</settlement>
</list>
<tree>
<country name="Suisse">
<noRegion>
<name sortKey="Stubinger, Stefan" sort="Stubinger, Stefan" uniqKey="Stubinger S" first="Stefan" last="Stübinger">Stefan Stübinger</name>
</noRegion>
<name sortKey="Berg, Britt Isabelle" sort="Berg, Britt Isabelle" uniqKey="Berg B" first="Britt-Isabelle" last="Berg">Britt-Isabelle Berg</name>
</country>
<country name="Allemagne">
<region name="Bade-Wurtemberg">
<name sortKey="Stricker, Andres" sort="Stricker, Andres" uniqKey="Stricker A" first="Andres" last="Stricker">Andres Stricker</name>
</region>
</country>
<country name="États-Unis">
<region name="État de New York">
<name sortKey="Berg, Britt Isabelle" sort="Berg, Britt Isabelle" uniqKey="Berg B" first="Britt-Isabelle" last="Berg">Britt-Isabelle Berg</name>
</region>
</country>
</tree>
</affiliations>
</record>

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HfdIndexSelect -h $EXPLOR_AREA/Data/Ncbi/Merge/RBID.i   -Sk "pubmed:26635486" \
       | HfdSelect -Kh $EXPLOR_AREA/Data/Ncbi/Merge/biblio.hfd   \
       | NlmPubMed2Wicri -a EdenteV2 

Wicri

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